As a holistic veterinarian, I am often approached by cat parents who are looking for a more natural approach to hyperthyroidism in their kitties. If you do a quick Google search on Methimazole (the oral medication commonly used to treat hyperthyroidism), it’s perfectly understandable why guardians are apprehensive about long term use of this drug. It’s important to understand that Methimazole is not the only treatment for this common condition. In this article, I will discuss the basics of hyperthyroidism in cats, what may be the underlying cause, and how I treat cats in my practice.
The Basics
Hyperthyroidism is the most common hormonal imbalance in senior cats. This occurs when the thyroid gland becomes enlarged and produces more thyroid hormone. The excessive amount of thyroid hormone causes weight loss, increased liver enzymes, vomiting, heart disease, and excitability/anxiety.
The majority of cases are easy to diagnose with a simple blood test of a total T4. On occasion, some cats may have a borderline T4 value, with vague symptoms. These kitties may require further diagnostics.
The Cause
Hyperthyroidism in cats is a relatively new disease, becoming much more prevalent only within the past 40 years. There has been much speculation within the veterinary community about what may have caused this increase in disease, and more research is needed. Culprits with the most evidence include fire retardants used in building materials and furniture. Additionally, there is some evidence that the products used to line canned food may also be linked to this hormonal imbalance. A genetic predisposition is also likely required.
Treatment
There are three traditional therapies available for hyperthyroidism:
- Methimazole
- Iodine Therapy
- Thyroidectomy
Thyroidectomy, the surgical removal of the thyroid gland, is rarely performed. For this article, the focus will remain with Methimazole and iodine therapy.
Methimazole
Methimazole is the most commonly recommended treatment. This drug works by interfering with the thyroid’s ability to make thyroid hormone. It is given either orally, or is absorbed through the skin (usually applied to the ear). While this drug is generally well tolerated, it can cause vomiting and lethargy in a subset of cats. On occasion, there are some cats that don’t respond to the Methimazole at all. Over the ten years that I have been practicing, I have seen this a handful of times, including with my own cat.
Pros: Methimazole is a relatively inexpensive treatment that can be extremely effective. Most cats feel great once their thyroid gland is regulating appropriately, and symptoms resolve within a couple months. If your cat is not interested in taking a tablet every day, the transdermal cream can be placed on the ear twice daily and is a relatively easy option.
Cons: Your kitty will need medication every day for the rest of his/her life. During the initial stages, your cat will need to have bloodwork done every 4-6 weeks, until the correct dosage has been reached. Generally, this is achieved on the first or second try. After the correct dosage is found, bloodwork should be rechecked every 6 months thereafter, to make sure thyroid levels are maintaining appropriately.
It should also be noted that some cats do not properly absorb the transdermal form of Methimazole, and require oral dosing only.
Iodine Therapy
This therapy involves the use of radioactive I-131. This may sound like the furthest thing from natural medicine, but keep reading! Iodine therapy has many advantages, and is considered the gold standard for treatment. I usually recommend this option as first line therapy. It is generally performed at a specialized facility, and involves only one treatment of iodine (I-131). I-131 specifically targets the thyroid gland, while sparing the surrounding structures (including the parathyroid glands). It is non-invasive, and requires only a few days of hospitalization to allow the radioactive particles to degrade. One set of follow up blood tests are required, and most cats are then cured for life!
Pros: One treatment is almost always curative, and no daily medication is required. It is extremely non-invasive, and you will not have to medicate your cat twice daily for the rest of their lives.
Cons: This is initially a more expensive treatment. In the state of Colorado, you can expect to spend $1,500 – $2,000. Treating with Methimazole, in addition to the maintenance blood tests required, will cost that (or more) over the span of several years. However, those costs are more spread out.
You will also spend at least four nights away from your kitty during treatment. This was the hardest part for me!
Diet Therapy
There is a prescription diet by Hills, that contains extremely low levels of iodine. This diet therapy can work, but has a couple of limitations. The palatability is poor, and many cats will not eat the diet. It can only work if it is the sole diet given, no other treats or foods allowed. Even a few bites of another food would exceed the iodine restriction threshold. This food is also low in protein, and can cause muscle wasting.
Hyperthyroidism and Kidney Disease
It is important to note that hyperthyroidism will cover up kidney disease. This occurs because the overactive thyroid hormone increases blood flow to the kidneys. When hyperthyroidism is treated, and blood flow returns to normal, the true kidney function is uncovered. Kidney disease is very common in older cats, and therefore most hyperthyroid cats have some degree of kidney disease as well.
Once treatment begins, expect that your kitty’s kidney values will rise. It is important to understand that the kidney disease was not caused by the treatment but, instead, was present all along.
You can learn more about my holistic approach to kidney disease here.
Natural Treatments
Over the years, I have had little to no success using herbs and other alternative therapies to reverse thyroid disease in cats. I believe that this is one instance when traditional therapy has the best answer.
Ideally, I would like to go back in time – clean up all the environmental pollutants, and take flame retardants out of everything! Going forward with the knowledge we have today, we can all make better choices for our cat’s environment. This includes purchasing furniture without fire retardants, using better building materials, and choosing non-toxic cleaners.
For now, and if finances allow, I recommend the iodine therapy first.
Wishing you and your feline friends health and happiness!
With love,
Hello Dr. Angie & to all the kitty lovers going through the stress and heartache of hyperthyroidism … I have a question in regards to using amlodipine with methimazole to slow the heart rate. Is this an option? I also have added carnitine 250mg a day which I learned helps reduce thyroid levels. I have a 12-year-old female Torti who was suddenly hit with this disease and she is losing too much weight. At this point I desperately want her to eat, to gain weight ..Any advice would be sincerely appreciated.
Hi Brandy. I so appreciate that you are advocating for your kitty and seeking answers to help her gain weight and feel her best. Dr. Angie does offer video consultations and would be a great resource to help develop a plan that is formulated for your cat’s specific needs. If this would feel supportive to you, you can access her availability at https://boulderholisticvet.com/video-consultations-with-dr-angie/
I hope that we can be of support to you and your sweet girl. JoJo
Since I found this thread 3 months ago when ours was diagnosed, we had success with Hills y/d, so thought I’d share my experience for anyone else looking.
Put her on a strict diet of the wet + dry food (luckily she eats both!) with nothing else. If your cat has hyperthyroidism, immediately avoid treats, dairy, seafood, seaweed, salt, oils.
After 1 month, she’d gained weight and seemed generally much less aggressively excitable when around food, and no longer crying to be fed all the time when she wasn’t.
Another 2 months after that, she had a blood test, she’d gained more weight and her thyroid levels were normal again.
Hoping things stay healthy long term, but glad we ignored the vet’s advice that the special diet “is rarely successful on its own” and avoided surgery or meds for now.
We may start mixing in raw unsalted chicken and bone broth on occasion, thanks to the advice from this article and posts in this thread.
I LOVE this update, Paul!!
How is she continuing to do?! Please keep us posted!
Warmly,
Claire
For all those struggling with hyperthyroidism and the diarrhea and vomiting what they don’t mention is the lack of B12 absorption. And for cats they can’t just eat more it has to be injected to absorb other wise they would not be lacking it if their bodies could normally absorb it. And ironically if you look up can a lack of B vitamins cause hyperthyroidism it’s goes hand in hand. I recommend B12 it’s what allows them to properly digest and absorb their other nutrients. My cat after just a few weeks on methimazole started having seizures lost all balance for minutes at a time rolling on the ground all I could do was hold her down until it stops the vet had no explanation. So I stopped the meds won’t go back. I figure B12 injections once a week for a month then once a month and I’m going to try and start up a holistic blend in a week or two after I know the methimazole is completely out of her system. Also to note while on it she was not of character and just slept in the corner all day except to eat and go potty since I stopped she is much more like her self again.
Hi there!
Thank you so much for sharing your experience!
Warmly,
Claire
Honestly, I believe thyroid issues and possibly even kidney issues are because they keep putting PLANTS in cat food! Also, it’s suspected that too much tuna can be a possible cause. It’s virtually impossible to find a commercial food that doesn’t have some kind of plant in it. I have a cat I suspect may be in the beginning stages of hyperthyroidism. She doesn’t sleep much during the day, runs around like a lunatic, playing or just to run, then scratches at her neck and begs for food. I live in an area where vets aggressively push drugs on pets, so unless she gets worse, I’ll avoid the vet for now and just feed her both raw and cooked meat to her taste. She likes rabbit, lamb and raw beef. The other cats love their raw chicken livers, but she only wants them cooked. I’ll be happy to report back on my plan.
Hi May,
Please definitely keep us posted!
Warmly,
Claire
I gather information research and believe in holistic treatment for pets as well as humans. I have 3 senior cats with this disease. My eldest Gigi passed away she was 24. The other 2 are 15 and 18, thank you for all the information posted. I will utilize. I wish Vets in Virginia would understand some people can’t afford to spend their life savings on pets although I know some people do.
Hi Jesse,
So glad you are finding value in this information, we are absolutely here for you and your kitties.
With love,
Claire
Your cats live long because you believe in holistic treatments. My cat gave birth to 8 kittens in 2 litters, we kept 2. All the 6 we gave away got every recommended shot and vet recommended foods, frequented the vet and all died years ago. Ours are almost 15 and 16, although mother cat has hyperthyroidism. I’ve Tried every trick in the book to give her the meds but she would just bring it back up so we left her alone . Today we found out the disease has worsened. Wish there was something else we could do. They’re still hunting, rough playing and ruling their world. In the last couple weeks she has had a few down days of poor appetite and low energy but then bounces back.
Orchid Evans,
I’m reading everything I can find in hopes of finding a solution for my boy-Rojo. I’m 60 now and Rojo is 10. He’s a big orange yello tiger of a boy and he’s my heart. I can’t even text what I need to for being too upset. He’s the first animal I’ve ever had in my life-ever.. I can’t believe what I’ve been missing out on all my life. Unconditional love, not once have I gotten frustrated or lost my compassion with him. He’s never been anything but perfect. It’s a blessing. I’ve been trying for three years to get him help but no vet could find a problem. I looked at the photos online and he fits the diagnosis perfectly, or hatefully I will say.
I just needed to tell you that I’m so sorry to read that your baby may be having problems or down days. I now feel the pain with everything in me. I don’t think my boy would survive an overnight vet stay of two or three days, we had to have one overnight stay because he was dehydrated during Covid and they wouldn’t let me stay and when I got him back home he wasn’t the same for a long time and I just can’t do it. I hear ppl say all the time, “We’ll I’ll just have to be buried with him” and now the thought of it appeals to me. I’ve lost my dad and a partner of over 15 years so I know the desire of not wanting to live without them is more than a desire. But we do live through it. I’m feeling sorry for myself and that’s not what I wanted to share with you, my heart is breaking for you and your baby. Please know I will carry you in my thoughts and be praying for comfort and healing and great days for you both. May these be days filled with love and joy. Only love to you.
Thank you for sharing your story.
John
John,
What a heartfelt sharing and extension of love to another going through something painfully hard. This was a brave and oh so kind share. I’m so incredibly sorry for all of the loss you have experienced as well. That is so difficult, and never really leaves us.
Your kitty sounds incredible!
We can do hard things. And even better, if we are all together as a community.
Big hugs,
Claire
Our cat, Misty, threw up the Methimazole pills. Her ears turned red after a month of the Methimazole gel. We are now giving her Methimazole in liquid form. It is almost a month. We are praying for the best. In
the meantime, I continue to search for something natural that will work. I believe there is a treatment or cure. I just haven’t found it yet.
Hi Terri!
How is your kitty continuing to tolerate the liquid form of Methimazole?
Hugs,
Claire
Hi, just read your comments on getting hyperthyroid medicine in your cat. I’ve been using a compounding pharmacy that mixes the methimazole into a solution and flavor it with marshmallow/tuna (yes, I guess cats love marshmallow flavor!). It’s only a small amount and I give with tuna or clam juice and have no problems with her taking it or keeping it down (I realize this could vary with cats though).
Wedgewood Pharmacy out of NJ has a website to provide this, or I’m now also using a local compounding pharmacy in MN now.
Hi Lise,
Thank you so much for sharing your successes with other pet parents!
YES! The marshmallow flavor is always a hit! We can also vouch for Wedgewood Pharmacy!
Warmly,
Claire
I’ve used Hyper Jia Bing with two of my hyperthyroid cats. It returned one of my hyperthyroid cats to a non hyperthyroid state for the time being. The other one is on a very low dose of transdermal methimazole which has worked out very well for him. The “hyperthyroid” food is very misleading, as it presents its deleterious health effects, and he is not a good candidate for the i-131 because of his kidney values. They both receive a quarter of a scoop twice a day (the scoop comes in the jar).
I purchase the product from our functional medicine veterinarian in North Carolina, however, the brand name is Jin Tang. It is distributed by Dr. Xie’s Jin Tang Herbal, Inc.
Web: http://www.tcvmherbal.com
Hi Leah,
Thank you for sharing your experience!
We use Jing Tang Herbal as well, and find them to be a very safe and reliable source for Chinese herbs.
Warmly,
Claire
Leah,
I have a 12 yr old cat, her name is Cali who has hyperthyroidism. We tried Methimazole and she became very ill. She got anemic, we almost lost her. We tried the ear paste as well. She’s definitely allergic to it. Surgery and Iodine therapy not an option.
Someone else I talked to mentioned Hyper Gia Bing to try. I’m going to lose her if I don’t do something. She’s lost weight, eating ravenously, and vocal.
I have an 18yr old hyperthyroid kitty Oreo who does fine on Methimazole. This reaction Cali had surprised me and the vet. I think I’ll try this.
Thankyou,
Lisa
I have used Thyroid Support Gold from PetWellbeing for years on several cats with great success.
Thank you for sharing this. In my process during this time and research process, I have tried unsalted bone broth with my cat and he loves it too and it satisfies him when mixed with chicken.
It is good to know that you have given him this REAL food as well as the Hill’s diet, despite instruction to exclusively serve Hill”s diet forever and that has been okay and not undermining the effectiveness of the Hill’s program.
Hi Sara,
I am so glad you found this helpful!
Warmly,
Claire
I have a cat with hyperthyroidism and tried first the Methimazole pills, which she couldn’t tolerate after two weeks; then I tried the same only using the transdermal method twice a day. That didn’t work either. I’m down to trying delivery of just once a day now to see how that works. I don’t have much confidence it will because she has vomited several times early this morning and later in the day.
I’m very interested in the unsalted bone broth and raw meat. I’ve been feeding my cats Friskies canned wet food plus Purina “natural” kibble. I want to change their diet but need help. I’m going to start with the bone broth. Is there any particular brand that is better? I’m also going to try the raw chicken/beef method.
Hi Barbara,
We very recently had a cat in Dr. Angie’s practice that did not respond to the I-131 treatment (UGH!) or the Methimazole. However, has a completely normal T4 now on an Rx diet (Science Diet YD for hyperthyroidism). Rx diets are not something we often promote, but it has been life-changing for this kitty!
As far as bone broth, have you seen Dr. Angie’s bone broth recipe here?
I hope this helps! Please keep us posted!
Hugs,
Claire
My cat is living proof that hyperthyroidism can be successfully treated with a low-iodine diet. My cat was diagnosed with hyperthyroidism at age 13, after a year and a half of eating a cat food that was “guaranteed” to cause weight loss. Yes, he had lost weight on that stuff, but he’d become very ill, too: he was vomiting several times a day, anxious and yowling all the time, drinking and peeing great volumes of water, was too weak to jump up on a sofa, he even got aggressive with me sometimes. The vet also said his heart rate was dangerously fast, and he was dehydrated despite all the water he drank. I learned later that the weight-loss cat food he’d been eating contained excessive iodine, which likely over-stimulated his thyroid gland and caused thyroid tumors. When the vet told me the treatment options I balked: either surgically remove his thyroid gland and give him thyroid hormone supplements the rest of his life, or give him anti-thyroid medication the rest of his life. Either would require many expensive vet visits to adjust his thyroid hormone levels until he was stable. I said no to both. I decided instead to try to cut iodine out of his diet. As soon as I changed his diet he stopped vomiting, and over the next several months all his other symptoms cleared up. The iodine-restricted diet meant no fish or seafood, no salted human foods because table salt is usually iodized, and no cat food containing iodine supplements in the form of kelp, potassium iodide or calcium iodate. I read all the cat food labels and at first I could not find ANY cat food that didn’t contain either fish or iodine supplements, or both. So I fed him raw poultry and unsalted bone broth. (My reasoning was that cats evolved eating whole animals including bones, and raw meat was only muscle, so I assumed bone broth should contain some calcium or whatever is in bones that he needs.) Eventually I found Hill’s prescription low-iodine YD food, and this is mainly what he’s been eating for almost 2 years now. I also give him raw ground chicken or turkey a couple of times a week, and unsalted bone broth every day because he loves it. He’s now 15 — and in perfect health! He recently had blood work done and all his blood levels are normal, including his thyroid hormone level. The vet said she’d never heard of treating hyperthyroidism with diet alone, but said I should keep doing what I’m doing because it’s clearly working.
Please consider that the cause of so much hyperthyroidism in cats may be the iodine supplements in cat foods. Ans please recommend that your clients try a low-iodine diet before more drastic treatments.
Hi Marcy,
THANK YOU so much for sharing your experience!
We have a kitty in the practice (currently) who is finding relief from his hyperthyroidism using just a low-iodine diet as well. He failed all other treatments and this diet is the ticket to his health.
I appreciate your thoughtful response and am so glad your kitty is feeling better!
Warmly,
Claire
Congratulations for figuring this out and THANK YOU SO MUCH for sharing it!!!! Are you comfortable with sharing where you buy the bone broth? Is there any special type you use? I’ve not dealt with it before and I want to do this correctly. Thank you so much again!!!! Janna :o)
Marcy,
Wow! Reading your post gives me some much needed hope! My kitty is 11 1/ 2 and was diagnosed with hyperthyroid officially over a year ago. I’ve tried methimazole (I find it makes her vomit more and her appetite is worse and she’s just so unhappy and lethargic). I’ve found 2 homeopathic vets in my area (New York City) and have tried those remedies without much success – she continues to lose weight and drinks/pees excessively. I’ve been making the majority of her food the past few months in combination with some herbal supplements I just started – Resthyro from NHV Natural Pet Products seems to be helpful, at least for her mood. She seems to fare pretty well when her appetite is good, but I’m at wits end here! I just connected with a center here who performs the I-31 radio iodine treatment, but am nervous about it and the traditional vet where she had her blood work done wants her to go back on methimazole (which raised her kidney levels the last time we tried it).
I’m going to try the unsalted bone broth and chicken and see how fares on that and keep on with the food I’ve been making her (adding taurine and a kidney supplement called AminAvast).
Any other advice, even just moral support, would be greatly appreciated! Coco is my best friend and I’m so sad for her every day!!
Best,
Marissa
How did the NHV work out? I just started talking to them but I have not talked to their nutrient doctor yet. I have mine on methimazole ( we are changing to a lower dose) and now working on changing his raw food diet w bones to boneless with me adding the supplements. I will not use prescription foods because I know what the ingredients are. I did have an issued with him eating crappy meow mix or whatever the neighbors feed the strays but since the T 4 numbers are in the range that seems to have stopped or been reduced greatly. Make sure your cats have no dental issues. Just like people bad teeth /gums lead to heart / kidney and other health issues.
With dietary options, I am curious about a somewhat homemade raw food/species appropriate diet. Just like commercially developed food for humans is known to cause modern day diseases, I suspect this could be the same for felines. Even so-called healthy ‘grain-free’ kibble has items added such as kelp which is loaded with iodine, and I am sure it is salted with iodized salt. The Science Diet ‘Thyroid Care’ formula has ‘corn and soy,’ which I do not believe to be species appropriate diet for felines. Cats do not feast on corn and soy in the wild, but both grains do have a negative effect on the human thyroid due to lectins in the corn, and phytoestrogens in the soy…so maybe this is helpful with with down-regulating thyroid hormones in felines. Anyways, with this train of thought, I am just wondering if modern day cat food could be the cause, and if a raw cat food diet could possibly be a forth option to look into.
Hi Bill,
These are GREAT thoughts, and I really think you are on to something here.
We know we’ve been feeding cats all wrong for many years. This is slowly becoming accepted knowledge in the veterinary community. I think that as the years progress, we will continue to learn how to feed our cats better including promoting healthy, more species-appropriate diets like canned or raw foods!
Thank you for your thoughts!
Warmly,
Claire
Has anyone had any experience treating feline hyperthyroidism with cbd?
Hi Julia,
I will love hearing the answers that you hopefully get for this question!
Unfortunately, in Dr. Angie’s practice, we have not had success treating hyperthyroidism with CBD. We did recently have a kitty in the practice fail the I-131 treatment (only 2% of kitties fail this!). In addition, he did not respond to daily medication or Chinese herbs. However, respond exceedingly well to a prescription thyroid diet. We do not usually endorse these diets, but this was one time where we say the thyroid levels return to normal after 1 year of feeding!
I hope this helps!
Warmly,
Claire
Hi Julia it’s definitely been helping my kitty to be more calm and lowered her heart rate. That’s all I’ve got for now with her being on the CBD about 2 months now.
There are most certainly homeopathic and herbal methods that can be used to treat hyperthyroidism.
Hi Terry,
After writing this article, Dr. Angie has been in contact with a colleague of her’s who uses Chinese herbs and other holistic options for treating thyroid disease!
What treatments have you seen work? We’d love to hear from you!
Warmly,
Claire
Hi Claire,
Any other knowledge found with Chinese herbs. I’m intrigued! I’ll write you all more (if helpful) about the homemade food / dietary routines I’ve been tweaking for my cat — who’s incredibly picky. I’ve developed some good combinations and recipes and observations I think. I’m actually a dietitian (for humans) but have found that my cat has been the most challenging “client” I’ve ever had! Will post a more detailed reply about food / recipes in the next few days. So glad to have found this string of posts, really SO helpful!!! xo
Hi Marissa,
Would LOVE to hear about the recipes!!!!
Hugs,
Claire
Thank you for sharing this. In my process during this time and research process, I have tried unsalted bone broth with my cat and he loves it too and it satisfies him when mixed with chicken.
It is good to know that you have given him this REAL food as well as the Hill’s diet, despite instruction to exclusively serve Hill”s diet forever and that has been okay and not undermining the effectiveness of the Hill’s program.
Hi there, thanks for the information! Have you tried treating many cats herbally for thyroid disease? I hope that doesn’t sound condescending! I am curious as a western herbalist with absolutely no experience in this and seeking some guidance for my own cat and would love any suggestions and specific experiences treating herbally you have had in your practice. Thanks a bunch!!
Hi Tara,
Great question!
Dr. Angie is not very versed in treating hyperthryoidism holistically. That said, she does have a colleague who has had great success with using Chinese herbs for kitties with hyperthyroidism.
I hope this helps!
Warmly,
Claire
What are the dosages for a 13 year old 8 lb cat for your following recommended meds?
Fish Oil. I use high doses of fish oil to help reduce inflammation and recommend Nordic Naturals.
Rx Renal by Rx Vitamins for Pets. This is a great blend of herbs that help improve kidney function.
Probiotics. I use Rx Biotic by Rx Vitamins for Pets. Probiotics can help improve digestion and reduce inflammation.
Hi Glen,
Good questions.
Here is the dosing for the following:
1) Nordic Natural fish oils – 0.5 mL (78 mg EPA/46 mg DHA) daily (this is their recommendation, you can likely increase from here and then back down the dosing if your kitty is experiencing vomiting or diarrhea).
2) Rx Renal – one capsule twice daily.
3) Rx Biotic – 1/2-1 scoop daily.
I hope this helps!
Warmly,
Claire
You need to try Hyper Jia Bing, a Chinese herbal for hyperthyroidism. I have used it on many cats. They eat it mixed in food, it relieves many of the symptoms and in one case the thyroid values returned to normal.
Hi Dr. Stange,
Thank you so much for this information! I passed it along to Dr. Angie, and she would love to give you a call to chat more.
You will hear from her soon!
Warmly,
Claire
Hi Dr Stange,
I have a 17 yo old cat who can’t tolerate methimazole. What is the dosage you use for Jia Bing, and where can I purchase it? Thank you!
Did you ever find out where to purchase the Jia Bing and how much to give? Thanks!
I hope you found your answer and your kitty is okay. One of our three was diagnosed with hyperthyroidism and the vet has him taking 1/16 tsp of the powder twice a day and she has him taking Nat Mur 30 homeopathic remedy. I’ve since read somewhere else that Nat Mur can help with hyperthyroidism in cats.